Key result
Statins remain first-line therapy for atherosclerotic cardiovascular disease prevention, while additional lipid-lowering agents and lifestyle interventions help address residual cardiovascular risk.
This review summarizes 25 years of statin therapy and discusses future directions for lipid management, including alternative agents and addressing residual cardiovascular risk.
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Maintains statins as first-line for ASCVD prevention; leaves open optimal adjunctive strategies for residual risk.
More than 25 years of clinical trial data have established statins as first-line therapy for the prevention and treatment of atherosclerotic cardiovascular disease. With regard to low-density lipoprotein cholesterol, a wealth of evidence indicates that ‘lower is better,’ although recent guidelines from the American College of Cardiology and the American Heart Association take a different approach. A variety of approved and experimental lipid-lowering agents may be used as supplements or alternatives to statin therapy in patient subgroups, including those with familial hypercholesterolemia, mixed dyslipidemia or statin intolerance. Strategies to achieve further reductions in low-density lipoprotein cholesterol, target high-density lipoprotein cholesterol and triglycerides or reduce inflammation may help address residual cardiovascular risk, although early lifestyle interventions are crucial to prevention strategies.
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Gotto et al. (2015) conducted a review in Atherosclerotic cardiovascular disease. Statins and other lipid-lowering agents was evaluated. Statins remain first-line therapy for atherosclerotic cardiovascular disease prevention, while additional lipid-lowering agents and lifestyle interventions help address residual cardiovascular risk.
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